Question

1. A staff nurse believes the client is bleeding excessively following a vaginal delivery. The nurse notifies the physician but the MD does not order any treatment. Can the nurse be found liable if the client dies or is harmed by the bleeding? What are the proper steps the nurse should follow to provide care for this client?

Answer 1

The physician's judgment may right in this regard, but yet the nurse is should take some nursing interventions to avoid any complications or emergencies and also ensure patient safety. The nurse will be liable if the patient dies of NURSING NEGLIGENCE. As we saw earlier nurse should perform certain nursing interventions regardless of physicians order any medicine or not. The nurse should continue monitoring and provide care if the patient continues to bleed along with low BP and increased heart rate physicians should be informed again.

Nursing Interventions

Assess for vaginal hematoma -If bleeding is due to vaginal hematoma, rest and application of an ice pack may be sufficient treatmentContinued, unrelieved pain may be due to hematomas or laceration

Moniotor vitals signs .Watch for signs of shock. Esepecially watch for decrease in BP and an Incrase in HR.

Manitain an accurate intake outpu chart.

Check and monitore patient's bleeding and  Monitor blood loss

• Type of bleeding ,
• Amount- should be no more than 1 perineal pad per hour Presence of clots

Perform uterine massage to stimulate contractions following delivery. Begin fundal massage and educate the patient on how to massage the abdomen to stimulate contractions. These contractions may help stop bleeding. Place patient on bed rest with legs elevated Rest and elevation of legs helps venous return and slows bleeding